BACKGROUND: Under wear particles stimulation, mononuclear macrophages, fibroblasts, and osteoblasts can produce a large amount of inflammatory factors, leading to periprosthetic osteolysis. But the precise mechanisms remain unclear. OBJECTIVE: To analyze the molecular biological mechanism underlying osteolysis induced by titanium wear particles . RESULTS AND CONCLUSION: Cleaned titanium particles stimulation induced an unbalanced ratio of RANK mRNA to OPG mRNA. Over-expressed RANK bound to RANK ligand and promoted osteolysis. No RANK mRNA expression was detected in the LPS group, but OPG mRNA expression was transiently increased at 4 hours. NF-κB/inflammatory cytokine, rather than RANK/OPG, is the main signal pathway for LPS to induce osteolysis. After LPS binding to titanium particles, these two signal mechanisms, RANK/OPG and NF-κB/inflammatory cytokine, have synergistic effects during artificial joint loosening.

Objective To investigate the clinical characteristics,treatment and prognosis of spine and spinal cord stab injury with foreign bodies retained in wound.MethodIn a group of 128 cases of spine and spinal cord stab injury that admitted to our department from January 1995 to November 2005,19 had foreign bodies retained in wound.The result of 19 cases were analyzed retrospectively.ResultOperations such as scrutinization of the spinal canal,clean-up of the hematoma,extraction of foreign bodies were performed according to different conditions for 19 cases of spine and spinal cord stab injury with foreign bodies retained in wound of 19 patients,one(5.3%) died,two happened cerebrospinal fluid leakage,one meningomyelitis and wound infection was observed.Of 14 cases with neurological injury,scores of ASIA scales of 13 patients increased after comprehensive rehabilitation treatment(P

Adult ; Faculty ; Female ; Humans ; Male ; Middle Aged ; Sampling Studies ; Sleep ; Surveys and Questionnaires ; Young Adult

Objective To develop a highly sensitive and accurate time-resolved immunofluorometric assay (TR-IFMA) for measurement of Dickkopf-1(DKK-1),as a novel serologic biomarker for lung cancer. Methods The study constructed a two-manoclonal-antibody "sandwich"-type assay and the sensitivity, within run CV and between run CV and accuracy were evaluated. Serum DKK-1 concentrations were measured by TR-IFMA in 120 healthy controls, in 72 benign lung disease patients, and in 212 lung cancer patients before surgery. The association between serum DKK-1 levels and clinicopathological features were evaluated. Results A standard curve for DKK-1 TR-IFMA had been developed with good sensitivity (0.08 μg/L). Both within run CV and between run CV were less than 6.5%. Accuracy studies, parallelism and precision data were determined and all found to be satisfactory. The validity of DKK-1 assay was confirmed by the good correlation between the results obtained by TR-IFMA and commercial ELISA (r=0.972, P=0.01). The serum levels of DKK-1 were higher in lung cancer patients 31.93(79.47-18.03) μg/L than in benign lung diseases 15.25(18.41-11.49) μg/L and in healthy controls 13. 90( 16. 91-11.02) μg/L DKK-1 levels were significant associated with the presence of distant metastases, as well as lymph node metastases and TNM stage, but not with patients' age, gender and tumor histology. At the cutoff of 22.63 μg/L, the diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the TR-IFMA for lung carcinoma were 68.4%, 92.2%, 82.1% ,90.6% and 72.5%. Diagnostic sensitivity and accuracy were higher for small cell carcinoma than for non-small cell carcinoma (70.7% vs 69.5% and 85.6% vs 80.7%, respectively). Conclusions A highly sensitive and reliable TR-IFMA for DKK-1 has been developed. The determination of serum DKK-1 levels may be useful for diagnosis and tumor staging of lung cancer.

Objective To evaluate the relationship between extracelluar signal?regulated protein kinase 1∕2 (ERK1∕2) and signal transducer and activator of transcription 3 (STAT3) signaling pathways involving in cardioprotection induced by diazoxide postconditioning in rats. Methods Sixty adult male Sprague?Dawley rats, aged 3 months, weighing 240-260 g, were randomly divided into 5 groups ( n=12 each) using a random number table: sham operation group ( SH group ) , ischemia?reperfusion ( I∕R ) group, diazoxide postconditioning group ( D group ) , ERK1∕2 inhibitor U0126 group ( U group ) , and STAT3 inhibitor Stattic group ( St group) . Myocardial I∕R was produced by occlusion of anterior descending branch of the coronary artery followed by 120 min reperfusionIn I∕R and D groups, 0?4% dimethyl sulfoxide 1 ml and 7 mg∕kg diazoxide ( in 1 ml of 0?4% dimethyl sulfoxide) was injected through the femoral vein at the onset of reperfusionIn U and St groups, U0126 100 μg∕kg and Stattic 500 μg∕kg were injected through the femoral vein at 10 min before reperfusion, and the other procedures were similar to those previously described in group DAt 120 min of reperfusion, the rats were sacrificed, and myocardial specimens were obtained from the left ventricle for determination of myocardial infarct size, cell apoptosis, and ERK1, ERK2 and STAT3 mRNA expression ( real?time PCR), and phosphorylated ERK1∕2 ( p?ERK1∕2) and phosphorylated STAT3 (p?STAT3) (using Western blot). Apoptosis index (AI) was calculated. Results Compared with group S, the myocardial infarct size and AI were significantly increased, and the expression of ERK1, ERK2 and STAT3 mRNA, p?ERK1∕2 and p?STAT3 was down?regulated in group I∕R. Compared with group I∕R, the myocardial infarct size and AI were significantly decreased, and the expression of ERK1, ERK2 and STAT3 mRNA, p?ERK1∕2 and p?STAT3 was up?regulated in group D. Compared with group D, the myocardial infarct size and AI were significantly increased in U and S groups, the expression of ERK1, ERK2 and STAT3 mRNA, p?ERK1∕2 and p?STAT3 was down?regulated in group U, and the expression of STAT3 mRNA and p?STAT3 was down?regulated, and no significant change was found in ERK1 and ERK2 mRNA and p?ERK1∕2 expression in group S. Conclusion STAT3 signaling pathway is located downstream of ERK1∕2 signaling pathway in the mechanism by which diazoxide postconditioning reduces myocardial I∕R injury in rats.

BACKGROUND:The effects of both conservative and traditional open reduction and internal fixation are dissatisfactory in the treatment of thoracolumbar fractures, however, minimal-invasive percutaneous pedicle screw-rod systems provide a new available method.
OBJECTIVE:To investigate the clinical effect of percutaneous pedicle screw fixation using Sextant minimal-invasive system in the treatment of thoracolumbar fractures.
METHODS:A total of 55 patients, who had undergone percutaneous pedicle screw fixation using Sextant system (25 patients) or open pedicle screw fixation (30 patients) for single-level vertebral body compression fractures in Department of Orthopedics, Renmin Hospital of Wuhan University from February 2011 to January 2013, were enrol ed in this study. They showed no neurological signs and symptoms. The operative time, intraoperablood loss, postoperative drainage amount, length of hospital stay, pre-and post-operative Cobb angle and anterior vertebral body height ratio were recorded and compared between two groups.
RESULTS AND CONCLUSION:Except two patients in open pedicle screw fixation group were lost after discharge, al other patients were fol owed up for 8-14 months. There were significant differences in operative time, intraoperative blood loss, postoperative drainage amount and length of hospital stay between two groups (P=0.000 0). The post-operative Cobb angle was significantly lower while anterior vertebral body height ratio was significantly higher at one week than those before fixation in two groups (P=0.000 0). No significant difference was found in correction loss between two groups at 8 months after operation. Experimental findings indicate that, percutaneous pedicle screw fixation using Sextant system has a satisfactory outcome in the treatment of thoracolumbar fractures. However, understanding the correct indications is very important for clinical application.

BACKGROUND:Though the effects of conservative or traditional open reduction and internal fixation in the treatment of thoracolumbar fractures are reliable and satisfactory for most cases, two methods also have shortages. Minimal-invasive percutaneous pedicle screw system provides a new available method. OBJECTIVE:To investigate the clinical effect of Sextant percutaneous pedicle screw system in the treatment of thoracolumbar fractures. METHODS:A total of 55 patients, who had undergone percutaneous pedicle screw fixation using Sextant system (25 patients) or traditional open internal fixation (30 patients) for single-level vertebral body compression fractures in Department of Orthopedics of Renmin Hospital of Wuhan University from February 2011 to January 2013, were enrol ed in this study. RESULTS AND CONCLUSION:Except two patients in traditional open internal fixation group were lost after discharge, al other patients were fol owed up for 8-14 months. Operative time, intraoperative blood loss, postoperative drainage amount and hospital day were better in percutaneous pedicle screw fixation group than in the traditional open internal fixation group (P<0.05). Compared with preoperation, the sagittal Cobb angle, visual analogue scale and Oswestry disability index after operation were significantly lower (P<0.05), while anterior vertebral body height ratio was significantly higher in each group (P<0.05). No significant difference was found in terms of correction loss and Oswestry disability index between two groups at 8 months after operation (P>0.05). The results show that percutaneous pedicle screw fixation using Sextant system has a satisfactory outcome in the treatment of thoracolumbar fractures. However, obeying indication strictly is very important for clinical application.

Objective To evaluate the role of ERK1/2 signaling pathway in mitigation of myocardial ischemia-reperfusion (I/R) injury by diazoxide postconditioriing in rats.Methods Sixty adult male SpragueDawley rats,aged 3 months,weighing 240-260 g,were randomly divided into 5 groups (n =12 each) using a random number table:sham operation group (S group),I/R group,vehicle group (Ⅴ group),diazoxide postconditioning group (D group),and ERK1/2 signaling pathway inhibitor U0126 group (U group).Myocardial I/R was produced by occlusion of left anterior descending branch of coronary artery for 30 min followed by 120 min reperfusion.In V and D groups,0.4％ DMSO and diazoxide 7 mg/kg (in 1 ml 0.4％ DMSO) were administrated,respectively,through the femoral vein at the onset of the reperfusion.In U group,U0126 was given through the femoral vein at 10 min before reperfusion,and the following procedures were similar to those previously described in group D.At 120 min of reperfusion,myocardial specimens were obtained for detection of myocardial infarct size,cell apoptosis (using TUNEL),and expression of ERK1/2 mRNA (by RT-PCR),total ERK1/2 (t-ERK1/2) and phosphorylated ERK1/2 (p-ERK1/2) (by Western blot).Apoptosis index was calculated.Results Compared with S group the myocardial infarct size and apoptosis index were significantly increased in the other groups,the expression of ERK1/2 mRNA and p-ERK1/2 was down-regulated in I/R,V and U groups,and no significant change was found in the expression of ERK1/2 mRNA and p-ERK1/2 in Dgroup.Compared with I/R group,the myocardial infarct size and apoptosis index we re significantly decrcaed,and the expression of ERK1/2 mRNA and p-ERK1/2 was up-regulated in D group,and no significant change was foundin the parameters mentioned above in V and U groups.Compared with D group,the myocardial infarct sizeand apoptosis index were significantly increased,and the expression of ERK1/2 mRNA and p-ERK1/2 was down-regulated in U group.There was no significant difference in t-ERK1/2 expression between five groups.Conclusion Diazoxide postconditioning mitigates myocardial I/R injury possibility through activating ERK1/2 signaling pathway in rats.

Background and purpose:Correct target positioning is an important factor affecting the precision of stereotactic body radiotherapy (SBRT) in patients with lung tumors. This study investigated the setup errors in patients with malignant lung tumors receiving SBRT with cone-beam CT (CBCT) and analyzed the factors influencing setup errors.Methods:Twenty-nine patients with solitary malignant lung tumors were enrolled in the study. Each patient underwent SBRT with CBCT before each treatment. Setup errors in CBCT were obtained according to the matched and planned CT images in anterior-posterior (AP), superior-inferior (SI) and left-right (LR) directions. The expanding margins of clinical target volume (CTV) to planning target volume (PTV) according to the analyzed setup errors were then calculated. And the influencing factors of setup errors were analyzed.Results:A total of 155 CBCT images from 29 patients were obtained during the treatment. The setup errors were (-1.68±3.62), (-1.34±3.90) and (0.36±2.15) mm in the AP, SI and LR directions, respectively. The absolute setup errors were (3.16±2.42), (3.29±2.48) and (1.74±1.30) mm in the AP, SI and LR directions, respectively. The suggested expanding margins of CTV to PTV were 9.6, 10.0 and 5.3 mm in the AP, SI and LR directions according to the setup errors. The setup errors in the AP direction of peripheral lesions and in the SI direction of inferior, right and metastatic lesions were relatively larger(P=0.007, 0.008, 0.000 and 0.000)..Conclusion:In patients with malignant lung tumors receiving SBRT, the setup errors were more obvious in the SI and AP directions. Tumor motion management techniques including CBCT, breath-holding technique are required to reduce the setup error in patients with lung tumors receiving SBRT.

Aim To develop a modified model of subarachnoid hemorrhage in rats. Motheds The SAH model was induced by injecting autologous blood into the cisterna magna without exposing the occipitoaxial ligament.The main modified point was a hole bored by a dental drill at the middle point of the boundary between the parietal bone and the occipital bone,then a catheter was inserted 8 mm to cisterna magna and the autologous blood was injected . Hemorrheological parameters were measured after the model was created.The intrinsic oversxidase method was used to show the microvessel of CA_1 region. The diameter, density ,and the aera of microvessel were measured and ananlyzed by Image-Pro Plus image analysis system. Results The total blood viscosity(?b) and erythroagglutation index(AL) in SAH model group increased significantly,however,the microvesse area and microvesse density in SAH model group decreased obviously. Conclusion The modified model of subarachnoid hemorrhage in rats is reliable and easy to operate on.